Background:

Despite the enormous current and projected burden of HCV-related illness, primary care physicians’ knowledge about testing and management of this clinical entity is inadequate. We examined the results of a targeted yet comprehensive intervention dministered to internal medicine residents aimed at improving their facility with the diagnosis and treatment of HCV.

Methods:

Internal medicine residents in three post-graduate years of training in a community-based teaching program participated in our study. The educational intervention consisted of several hours of HCV-related formal didactic lecture, handouts and self-evaluation questionnaires covering the natural history, epidemiology, screening, diagnosis, prevention and treatment of HCV over a ten-month period. Residents were also exposed to a primary care continuity clinic with many chronically infected HCV outpatients, both treatment-naïve and on interferon-based combination therapy. Ten pages of questionnaires evaluating knowledge in the aforementioned areas were administered pre- and post-intervention. Comparative data were analyzed using student’s t-test and ANOVA (analysis of variance).

Results:

Resident participants were equally distributed among three post-graduate years of training. A total of 29 residents participated in the intervention and pre-intervention testing, and 28 residents completed the post-intervention questionnaire. Results were partitioned into three groups including A: HCV natural history, epidemiology, screening, diagnosis, and prevention, B: HCV treatment and side-effect management and C: HCV comprehensive, which included both A and B. The mean percentage of correctly answered questions at baseline was 13.14%; however, post-intervention, the overall improvement in mean test scores was 66.1%. Residents knowledge significantly improved in all areas tested (A, p=0.00004; B, p<0.0000001; C, p<0.0000001). Knowledge differed significantly by post-graduate level of training before the intervention (A, p=0.005; B, p=0.003; C, p= 0.001), but not after the intervention (A, p=0.78; B, p=0.12; C, p=0.19), even when treatment experience was held constant. This disparity further supports the effectiveness of the teaching intervention.

Conclusion:

We confirmed that hepatitis C knowledge is inadequate among internal medicine physicians in training. A comprehensive educational intervention administered to internal medicine residents over a ten month period was successful in improving physicians’ knowledge in all HCV-related areas tested. Similar educational interventions should be studied in more diverse primary care training settings.